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Any person who has atypical neurological development will likely have atypical psychological development as well. This means when everybody else (the neurotypicals) have the same development (psychosocial, emotional, and cognitive), the neurodiverse definitely has a different developmental pattern.

Now, before explaining psychological problems in neurodiversity, let me share what is the normal (or neurotypical) psychological development (that is, a person without learning disabilities, developmental disorders, and emotional disorders).

Image courtesy of natural-passages.com. Psychosocial development by Erik Erikson.

Okay. I’ll end the list here. The first table regards to the psychosocial development in humans developed by Erik Erikson. At each stage of human development, there is a specific crisis each must face. For example, the infant’s trust vs mistrust crisis. Here, the infant must learn to trust her surroundings, her parents (particularly mother), caregivers, and environment. If these needs are not met, the infant will fail to learn trust and instead will learn mistrust and will be afraid of everything around her. If crises are managed well, the psychosocial development of a person will flow chronologically. However, any negative response to a crisis will suspend a person’s psychosocial development and that is detrimental to the person’s being.

Now, move to the second table. It is Jean Piaget’s theory of cognitive development. This theory is about the nature and development of human intelligence.[1] According to Piaget (who is a gifted person in psychology, see my article on giftedness), cognitive development was a progressive reorganization of mental processes resulting from biological maturation and environmental experience. He believed that children construct an understanding of the world around them, experience discrepancies between what they already know and what they discover in their environment, then adjust their ideas accordingly.[1][2] He regarded the child as a philosopher who perceives the world only as he has experienced it. Therefore, most of Piaget’s inspiration in cognitive and intellectual development came from observations of children.[3] The theory of cognitive development focuses on mental processes such as perceiving, remembering, believing, and reasoning. Reasoning is the essence of intelligence, and reasoning is what Piaget studied in order to discover “how we come to know.”[4] Piaget believed that cognitive development is cumulative; that is, understanding a new experience grows out of a previous learning experience.[3] Accordingly, there are four stages of cognitive development[3]:

Here, these four stages have different modes of learning. At the beginning of life, a baby uses her reflexes to navigate the world (sensorimotor). Then, from toddler to preschool years, she uses only her point of view (egocentrism) to navigate the world (preoperational). Her language matures, but their thinking is based on intuition and still not completely logical. They cannot yet grasp more complex concepts such as cause and effect, time, and comparison.[5] Following the elementary years, the child now demonstrate logical, concrete reasoning (concrete operational). Children’s thinking becomes less egocentric and they are increasingly aware of external events. They begin to realize that one’s own thoughts and feelings are unique and may not be shared by others or may not even be part of reality. During this stage, however, most children still can’t think abstractly or hypothetically.[5] As they move into adolescence, are able to logically use symbols related to abstract concepts, such as algebra and science. They can think about multiple variables in systematic ways, formulate hypotheses, and consider possibilities. They also can ponder abstract relationships and concepts such as justice.[5] Take note that Piaget acknowledged that some children may pass through the stages at different ages than the averages noted above and that some children may show characteristics of more than one stage at a given time. But he insisted that cognitive development always follows this sequence, that stages cannot be skipped, and that each stage is marked by new intellectual abilities and a more complex understanding of the world.[5]

The summary of both Piaget’s sensorimotor development and Erikson’s early psychosocial developments are found here at this picture:

Image courtesy of buzzle.com. An illustrated normal development from infancy to toddlerhood. Piaget’s sensorimotor cognitive development and Erikson’s trust vs mistrust, autonomy vs shame, and initiative vs guilt, all summed up here.

There are more theories regarding psychological development in humans like Freud’s psychosexual development and Sullivan’s interpersonal development, Kohlberg’s stages of moral development, and so forth. These theories explain the normal development of the human mind, personality, and the whole personhood itself. Any delay or obstruction can cause significant halt in the person’s total development and may lead to various psychological and mental and even personality problems that may cause distress to the person.

But what about psychological development for people in neurodiversity?

Image courtesy of Middlebury College.

For neurodiverse people, psychological and cognitive development may be different from the rest of us neurotypicals. This has something to do with atypical brain development (as in the case of autism) or atypical learning styles (in case of learning disabilities) or cognitive abilities (giftedness, intellectual disability). This difference in psychological development causes various psychological problems for people in neurodiversity ranging from depression to anxiety to substance abuse and suicide.

Let’s cite autism as an example of neurodiversity with different psychological development (excerpt from Psychology Today):

Children with autism do not follow the typical patterns of child development. In some, signs of future problems may be apparent from birth. Other children develop typically at first, but between the ages of 18 and 36 months, their development stagnates. Parents may notice that they begin to reject social contact, act strangely, and even lose language and social skills that they have already acquired. In other cases, there is a plateau or leveling of progress, and the difference between the child with autism and other children the same age becomes more noticeable.[6]

Here, the autistic child clearly develops differently and more delayed than the neurotypical children. The autistic child may not reach a particular milestone (let’s say she cannot move from preoperational to concrete operational cognitive development) because of her different mental and psychological development.

Another example of neurodiversity with different psychological development is ADHD. Because ADHD is characterized by short attention span, hyperactivity, and impulsivity, many kids with ADHD tend to suffer from school difficulties and social rejection. Here, I can say that the ADHD child may have halt in Erikson’s industry vs inferiority where he, because of his ADHD, may perceive himself as inferior to his peers in relation to task mastery (studying). The same goes with other learning disabilities where people having it have a sense of inadequacy.

The more difficulty neurodiverse people develop is in the social domain. Because they are different from most humans, they tend to be socially isolated (usually failing Erikson’s intimacy vs isolation where they become isolated) and can either become depressed or harbor anger to other people, become needy, and may become suicidal.

People in neurodiversity experience lots of psychological struggles more than neurotypical individuals thus experience more psychological illnesses and disorders. Why? Because their atypical neurological development also means atypical psychological development.

Image courtesy of Huffington Post. People in neurodiversity do experience psychological problems more than neurotypicals.

What are some of the common psychiatric disorders experienced by people in neurodiversity?

Anxiety – people in neurodiversity are more anxious than neurotypicals because neurodivergents have different ways of dealing with the world, which can be weird or unacceptable to the majority (neurotypicals). Because of this, neurodivergents experience anxiety.

Depression – when a neurodivergent experiences more and more failures and social isolation, that’s a perfect recipe for depression. This is true especially when a neurodivergent gives up trying new things (learned helplessness) and begins to be aggressive turned inside (depression); hence, depression develops.

Phobia – a phobia is excessive and irrational fear of a real or perceived object or occurrence. Neurodivergent people, because of traumas they experience in life, may develop phobias of specific objects (i.e., sports equipment for a person with dyspraxia) or social events (in case of autism and language disorders). They develop phobias in order to protect themselves from further humiliation, which I’ll bring another psychological problem in neurodiversity.

Obsessive-compulsive disorder (OCD) – having a neurodiverse condition can also have repeated failures in motor skills (dyspraxia) or failures in understanding mathematical concepts (dyscalculia), which may cause obsessions in failures, which could turn into compulsions of excessive perfectionism (obsessive-compulsive disorder) in order to compensate the disabilities in neurodiversity. Not a good compensation, as OCD is one extreme form of anxiety. If disabilities are not properly addressed, the end result will be more anxiety, depression, and procrastination (not really doing anything to solve a problem, just obsessing with how a particular problem is solved without action), which could also lead to underachievement in life areas.

Post-traumatic stress disorder (PTSD) – when repeated failures and rejections are experienced by the neurodivergent (i.e., bullying, always failing at school, social rejection), he or she may develop post-traumatic stress disorder, is an anxiety disorder that can develop after a person is exposed to one or more traumatic events[7] such as bullying. Symptoms include disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, which does continue for more than a month after the occurrence of a traumatic event.[7][8] A neurodivergent can experience PTSD after years of rejection and failures.

Eating disorders – neurodivergents who are always rejected by peers would become obsessed with their looks (weight included), which can lead them to have various eating disorders (very abnormal eating habits) like anorexia nervosa (eating little to nothing to decrease weight even if already underweight), bulimia (binge eating followed by induced vomiting/excretion), binge-eating disorders (eating excessively even if it causes a person to be obese), and so forth. This is common for people with autism spectrum disorders (click this link for more details) because of their obsession with details and are longing to be part of a group, hence forcing their bodies to become “perfect” just to be accepted by a group.

Suicide/suicidal tendencies – because the neurodivergent feels she’s different and it seems that no one could understand her (these occur in undiagnosed neurodivergents), she will resort to self-harm or self-destruction, which is ultimately a tragedy for any neurodivergent.

It’s very disheartening for neurodivergent people to experience these psychological problems. What to do to avoid these problems in neurodiversity?

Proper assessment of the neurodiverse condition is a must in order to truly identify the key problems of a neurodivergent person. By properly identifying either a learning disability, developmental disorder, or emotional/behavior disorder, the neurodivergent person will finally identify who he really is, will have an introspection of himself (though it will take months to years before acceptance just like what I did), then he will develop healthy coping strategies (i.e., individualized education plan, shift to a job that truly suits his strength, social skills training, etc.) in order to reach his full potential.

Image courtesy of lifehacker.com. Self-awareness of the neurodiverse condition is a key to alleviating psychological problems in neurodiversity.

Self-awareness and self-acceptance of the neurodiverse condition is also a must for the neurodivergent in order to alleviate his psychological problems. Yes, someone can be aware of his condition, but if he cannot accept it as part of his personhood, then nothing happens. There is no introspection. Without it, the neurodivergent still encounter problems because of his failure to accept himself as who he is. This is hard at first, because being different from majority (neurotypicals) would mean struggle in self-acceptance, lest acceptance by the group. But when a neurodivergent finally becomes aware of his condition and accepts it, then change will occur because he can learn to navigate the world with his “real” self without compensating to psychological problems.

Love and support from family and friends is also a must. And it’s not conditional. Families and friends of neurodivergent people should be educated and/or be aware of the neurodivergent’s condition and unconditional love and support is ever needed in order for the neurodivergent to feel accepted and loved. Neurodivergents usually have a hard tie when it comes to acceptance because of his hard-wired difference. Nevertheless, when he is valued and accepted, he will have the courage to go on in this world and he will feel that he “belongs” alongside all people, whether be neurodivergent or neurotypical.

Final words: Being a person in neurodiversity whether having learning disabilities or developmental disorders doesn’t exempt him or her from having various psychological problems whether brought by neurodiversity or other life trials. This means a neurodivergent is similar to the neurotypical; in short, he is human too but with different brain makeup.

Let me share my own experience: As a girl diagnosed with ADHD back in college, I have had experienced much difficulties in navigating the world of neurotypicals. From having best friends (and lovers) to keeping a job, I did struggle a lot just to survive this world. Particularly when I haven’t been diagnosed back in high school. I didn’t know my friends were starting to date and have relationships, while I was stuck on anime, dolls, and other childish stuff, thanks to my constant daydreaming. It came even worse when I became a nursing student, when my ADHD symptoms became apparent. I easily forgot nursing procedures (luckily, I did learn them in the long run before graduation), miss class discussions, and always wanders while having a conversation. From there, I was reffered to a psychiatrist and finally was diagnosed. But the symptoms still didn’t disappear even with medication (atomoxetine). Though my meds did control my ADHD symptoms a bit, my hyperfocus never disappeared, and that became a problem after college. I did hop from one job to another, thanks to my ADHD. The worst experience I had with this is the gross discrimination I had from my boss. Upon assessing for ADHD, I was immediately relieved form my nursing job just only because of my ADHD without considering my positive abilities.

Unfortunately, there are no laws in the Philippines that protects neurodivergent (someone with neurodiverse condotions like ADHD, autism, and the like) people against discrimination, so I usually end up jobless (and loveless). Fortunately, I currently have a part-time online job, but I am stay at home. I am also having recurring depression and anxiety.

This experience is really traumatic to the neurodivergent. Now, the question is, how to survive the world if you are neurodivergent like me?

First and foremost, you must know or be aware yourself (or your relative, child, friend, lover, etc.) that you have a neurodiverse condition or at least be diagnosed with it. Imagine how hard it is to live right without knowing what’s wrong with you. When I was finally diagnosed in 2007, I had least a relief about my symptoms (but I do suspect that I have dyspraxia/DCD and/or HFA/Asperger’s). However, if I was diagnosed earlier, I should have never took nursing as a profession due to high demands of concentration with patients and lots of routine activities. Unfortunately, ADHD was not so known in the Philippines during that time.

Like a stranger in the desert, a neurodivergent must navigate the desert of neurptypicals…

Without being aware of undiagnosed neurodevelopmental disabilities, a neurodivergent will never understand what’s going on with him or her and thus will have difficulty in making life choices from selecting a career to starting a relationship and/or family and so forth and wil have a high risk.of having depression, anxiety, posttraumatic stress disorder, substance abuse, or being chronically unemployed or divorced.

After awareness and diagnosis, you have to know your strengths and weaknesses. By being aware of your traits, you will know what type of jobs will be suitable for you and avoid jobs that might jeopardize yourself or other people. For example, an autistic loves long hours of work at computers but cannot hold long conversations, so he or she should not get jobs that require client communication like receptionist, social worker, or teacher. Instead, he or she should get jobs that require minimal to no client exposure like computer programmer, librarian, and the like.

Then, try to observe and study the ‘hidden’ social rules of neurotypicals. The social rules are nonverbal communication like body language, gestures, sarcasm, and figures of speech. Neurodiverse people usually cannot read and comprehend these social rules just like the way dyslexics cannot read letters. How is it done? It sounds like it’s very difficult especially for someone with ADHD like me and also for autistics. Here’s a tip: watch your favorite TV program and observe each character’s communication style and also how he or she acts. Still clueless? Read a psychology or social skills book and study all nonverbal communication and other social graces. I didn’t mean to exactly mimic neurotypicals. Just understand their perspective, and voila, you will be able to adjust a little to their world like a soldier planning a strategy to win a battle.

Ready, aim! By having a well-planned strategy, you will be able to win the battle for living with neurotypicals.

Get support. Your family and friends (true firends love you as you are no matter what) will understand and support you once they understand or become aware of your condition. Try also to join support groups with the same condition so that you get enough support and also tips on daily living as a neurodivergent.

Finally, believe in yourself that you can survive the neurotypical world. A positive thinking will boost your morale and move on with your life. Try also to pray for believers or try to meditate and/or self-reflect for non-believers to have a better understanding of yourself.

That’s all I can give on advice on survival of a neurodivergent. Lucky are you with enough awareness and support in the developed world. As for me here in PH (Philippines), awareness has begun only a decade ago and is only known in the medical field and the upper class, so I am trying to survive along with my mom (I think she has suspected ADHD, dyspraxia/DCD, and dyscalculia) using these tips above.

The earlier the identification and intervention of the neurodiverse conditions, the better will be the outcome and the potential of becoming successful in life.

P.S. We neurodivergent people have more ‘out-of-the-box’ thinking and may solve the world’s biggest problems given enough support.

Maybe you know someone who always trips and bumps into many objects (maybe more that once a day). He or she can’t live a day without spilling food, tripping on the floor, bumping into walls or posts or even other people, or misplacing or dropping things. Or maybe you have watched anime, J-dorama, and K-drama series, even Hollywood films and American TV series, with a lot of clumsy protagonists.

Not really. It DOES hurt to the clumsy person. Literally and figuratively hurt. Although clumsy people are funny, they usually struggle to finish tasks completely, keep balance, and use a skill without much difficulty everyday despite their conscious efforts. This condition is called developmental coordination disorder (DCD) or dyspraxia (also known as motor skills disorder or specific developmental disorder of motor function).

What is dyspraxia?

Dyspraxia is the term used when someone has an inability to carry out and co-ordinate skilled, purposeful movements and gestures with normal accuracy. Someone with dyspraxia has difficulty planning and organising their thought processes (planning what to do and how to do it).[1] Although most people do expreience accidents and mistakes, a person with dyspraxia (dyspraxic) does experience accidents and mistakes more frequently than the neurotypical person. It doesn’t necessarily mean that the dyspraxic is dumb or airheaded as it is portrayed in media.

Dyspraxia is a common disorder affecting fine and/or gross motor coordination in children and adults. It may also affect speech. DCD is a lifelong condition, formally recognised by international organisations including the World Health Organisation.[2] Because it is lifelong, most daily activities become difficult to the dyspraxic person.

But mistakes happen to everyone including me. Maybe dyspraxics should just learn to practice.

Er, yes, but dyspraxics DO experience more dificulty than the rest of us. Here’s why.

Dyspraxia is a chronic neurological disorder beginning in childhood that can affect planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body.[3] It is like broken electrical wires that cannot deliver electric current properly to the appliance that may cause malfunction.

What causes dyspraxia?

Nothing is known about the exact cause of dyspraxia, but some factors have been hypothesized as causes of dyspraxia. These include immaturity of the nerves at the time of conception. Dyspraxia may be caused by a problem with the nerve cells that send signals from the brain to muscles. Children who were born prematurely, had low birth weights or were exposed to alcohol in the womb may be more likely to have dyspraxia.[4]

Certain neurones in the brain, called motor neurones, do not seem to develop and mature as quickly in someone with dyspraxia. As a result, they are not as effective in transmitting information from the brain telling the muscles to move.[1] Because of this, dyspraxics have weak motor coordination that makes it hard for them to do movements correctly or smoothly.

What are the symptoms of dyspraxia?

(C) Kyoto Animation. All rights reserved.
Oops! You really don’t know whether this girl is stupid or is dyspraxic.

Symptoms vary per person and also its severity. But here is the list of general symptoms of dyspraxia:

Gross Motor Symptoms – the general whole body movement like running and dancing is difficult to execute by the dyspraxic[3]:

-Poor timing[5]
-Poor balance[5][6] (sometimes even falling over in mid-step). Tripping over one’s own feet is also common.
-Difficulty combining movements into a controlled sequence.
-Difficulty remembering the next movement in a sequence.
-Problems with spatial awareness,[6][7] or proprioception.
-Some people with developmental coordination disorder have trouble picking up and holding onto simple objects such as pencils, owing to poor muscle tone and/or proprioception.
-This disorder can cause an individual to be clumsy to the point of knocking things over and bumping into people accidentally.
-Some people with developmental coordination disorder have difficulty in determining left from right.
-Cross-laterality, ambidexterity, and a shift in the preferred hand are also common in people with developmental coordination disorder.
-Problems with chewing foods.

Fine Motor Symptoms – movements of only body parts (arm, hand) that do small work like sewing, using knife and fork, combing hair, and applying cosmetics – these are also difficult to the dyspraxic.[3] Handwriting also is not coordinated. Problems associated with this area may include[3]:

-Learning basic movement patterns.[8]
-Developing a desired writing speed.[9]
-Establishing the correct pencil grip[9]
-The acquisition of graphemes – e.g. the letters of the Latin alphabet, as well as numbers.

Image courtesy of wikipedia.org

Example of fine motor skill deficit in dyspraxia shown in this girl completing a globe puzzle.

Developmental Verbal Dyspraxia or Childhood Apraxia of Speech:

This symptom involves dificulty in language expression not as a result of muscle weakness, paralysis, or deafness, but of the brain having difficulty coordonating the muscle movements to say sounds, syllables, and words.[10]

These are general symptoms. Here are the signs of dyspraxia per age range[4]:

Waring Signs in a Toddler:

Is a messy eater, preferring to eat with fingers rather than a fork or spoon
Is unable to ride a tricycle or play ball
Is delayed at becoming toilet trained
Avoids playing with construction toys and puzzles
Doesn’t talk as well as kids the same age and might not say single words until age 3

Warning Signs in Preschool or Early Elementary School:

Often bumps into people and things
Has trouble learning to jump and skip
Is slow to develop left- or right-hand dominance
Often drops objects or has difficulty holding them
Has trouble grasping pencils and writing or drawing
Has difficulty working buttons, snaps and zippers
Speaks slowly or doesn’t enunciate words
Has trouble speaking at the right speed, volume and pitch
Struggles to play and interact with other kids

Warning Signs in Grade School or Middle School:

Tries to avoid sports or gym class
Takes a long time to write, due to difficulty gripping pencil and forming letters
Has trouble moving objects from one place to another, such as pieces on a game board
Struggles with games and activities that require hand-eye coordination
Has trouble following instructions and remembering them
Finds it difficult to stand for a long time as a result of weak muscle tone

Warning Signs in High School:

Has trouble with sports that involve jumping and cycling
Tends to fall and trip; bumps into things and people
May talk continuously and repeat things
May forget and lose things
Has trouble picking up on nonverbal signals (gestures, body language, figures of speech) from others

How is dysraxia diagnosed?

A diagnosis of dyspraxia can be made by a clinical psychologist, an educational psychologist, a pediatrician, or an occupational therapist. Any parent who suspects their child may have dyspraxia should see their GP (general practitioner, primary care physician), or a special needs coordinator first.[11]

Assessment for dyspraxia includes developmemtal history, intellectual abilities, and gross and fine motor skill testing.[11] There, the assessor will test specific skills including hand grip, balance, and touch sensitivity. This will be compared to the developmental milestones of the typical child. Comparing children to normal rates of development may help to establish areas of significant difficulty.[3]

However, dysraxia is very hard to diagnosed becauuse it does not present symptoms obviously like ADHD (being hyperactive) or autism (being aloof). It is also difficult because the dysraxia/DCD is not recognized yet in most parts of the world except in English-speaking countries and some parts of Europe (in Scandinavia, dyspraxia is called deficits in attention, motor control and perception (DAMP)[12]). Especially when the health care peovider is not completely aware of the disorder, the diagnosis may not be made clearly and dyspraxia may be missed.

How is dyspraxia treated?

There is no cure for dyspraxia, but there are a lot of mamagement techniques needed to cope with dyspraxia. The earlier the detection, the better the outcome of dyspraxia management. Therapies include occupational therapy, speech and language therapy, and physical therapy. Other strategies include educational modification like one-on-one coaching[13] so it will be easier fof the dyspraxic to acquire skills and knowledge.

For adults, structure and routine at work stations can help a dyspraxic employee get the work done. Office technology like ergonomic office furniture and electronic gadgets and word processors can also help. Breaking own their work into manageable chunks and to use different coloured folders for different tasks to help with organisation. Allowing regular breaks can improve productivity.[14]

If the diagnosis is made during late childhood to adulthood, the dyspraxic has already acquired anxiety, depression, or emotional disturbances due to repetitive failure at school or work, social isolation, and discrimination made be colleagues, schoolmates, and teachers. Usually, dyspraxics have low sense of self-esteem, thus, psychological counselling is also recommended. Medications like antidepressants can also help.

What happens if dyspraxia is not diagnosed?

If dyspraxia has not given intervention, life will be hard for the dyspraxic. He or she will continually struggle at school especially with skills like art, music, physical education or gym, and crafting. Because dyspraxics cannot read nonverbal communication, they are often struggling in making and keeping friends and romantic relationships, which in turn may leave the dyspraxic isolated and depressed. By the time the dyspraxic reaches adulthood, he or she has the high risk of unemployment, underachievement, and divorce or having unstable relationships.

Awareness of dyspraxia

Interest in studying dyspraxia started in the 1960s[15], although the term dyspraxia is not yet coined. In 1972, A. Jean Ayres called dyspraxia disorder of sensory integration.[3][16][17] Dr Sasson Gubbay called it the ‘clumsy child syndrome’ in 1975.[3][18][19][20] Dyspraxia is only coined
by the American Psychiatric Association (APA) in 1987[21], though Samuel Orton first coined developmental dyspraxia in 1937.[22]

Since dyspraxia is only a recent diagnosis, still most people are not yet aware of the condition, which may conclude that there are people with undiagnosed dyspraxia and may be struggling in their everyday lives. More awareness is needed to recognize dyspraxia especially in most parts of the world.

How common is dyspraxia?

According to Dyspraxia Foundation USA, 1 out of 10 people have dyspraxia[23]. It is 4 times more common in males than in females, and it is hereditary.[3]

Can a dyspraxic be successful?

Yes with early detection and mamagement. Dyspraxics can also have strengths like in literature, music, acting, math, and science, and computer studies too. Below are some people with diagnosed or suspected dyspraxia[24]: